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New Hampshire rates for HCPCS J0256

Injection, alpha 1-proteinase inhibitor (human), not otherwise specified, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.19 / $5.81 / $10.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.46 / $5.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.44 / $9.01 / $23.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.19 / $5.46 / $5.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.15 / $5.46 / $5.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.46 / $5.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $8.86 / $16.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.46 / $5.46
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.87 / $4.51 / $6.83